TOPLINE: An emergency department (ED) process improvement package focusing on suicide prevention using evidence-based practices reduced suicidal behavior in patients at risk for suicide.
- The National Action Alliance for Suicide Prevention and The Joint Commission consider ED as an essential setting for suicide prevention; but EDs often fail to use all suicide-related best practices.
- This ED-SAFE 2 cluster randomized trial was conducted in eight EDs across the United States.
- Each site received lean training and built a continuous quality improvement (CQI) team to review the current suicide-related workflow in the ED, identify areas for improvement, and execute initiatives to improve care.
- Across three 12-month phases (baseline, implementation, and maintenance phases), data from 2761 suicide-related ED index visits that led to discharge were evaluated.
- The primary outcome was suicide-related composite measure of ED visits due to suicidal ideation, attempt, or death within 6 months of the initial ED visit.
- During the 6-month follow-up period, 19.8% of patients had one suicide-related event, of which 0.3% died by suicide and 19.5% visited the ED due to suicidal ideation or attempt.
- The risk for suicide composite was 39% (adjusted odds ratio, 0.61; 95% CI, 0.46-0.79) and 43% (0.57; 0.43-0.74) lower in implementation and maintenance phases, respectively, than the baseline phase.
- The suicide composite rate reduced by approximately 6% in the 12-month period between the implementation and maintenance phases.
Researchers wrote, “CQI represents an implementation approach that is compatible with the culture of the US healthcare setting, allowing EDs to own suicide-related practice changes and sustain them over time.”
The ED-SAFE 2 Investigators published the study in the JAMA Psychiatryon May 17, 2023.
- Reliance on electronic medical records to identify eligible suicide composite outcomes led to potentially underestimated rates.
- The study had insufficient power to identify differences in deaths by suicide or attempts because of the rarity of suicide deaths.
The study was supported by the National Institute of Mental Health. Zeger W and Millet I received research grants from the University of Massachusetts and National Institutes of Health, respectively. Millet I also received personal fees from the National Institutes of Health.
For more news, follow Medscape on Facebook, X (formerly known as Twitter), Instagram, and YouTube.
Source link : https://www.medscape.com/viewarticle/emergency-department-process-improvement-boosts-suicide-2023a1000o25?src=rss
Publish date : 2023-10-03 09:01:55
Copyright for syndicated content belongs to the linked Source.